In the summer of 2013, I was luckily chosen to be one of the exchange students of "Global Research Experience in Advanced Technologies" (GREAT) program. My work was to study the behavior of Chinese patients and generate suggestions for a health system design project. Within 50 days I completed the explorative research in both qualitative and quantitive methods independently. My work was honored with "Outstanding Research Performance of GREAT program", 2013.
Mentor: Professor Tingrui Pan, University of California, Davis
Duration: Jul 2013 - Aug 2013, 8 weeks
Research Methodology: Interviews, Focus Group, Survey, Reaction Time Experiment, Field Study, User Experience Journey
*Due to a non-disclosure agreement with Professor Pan, only some selected highlights are presented here. If you are interested in more about my experience, please feel free to contact me now!
Chinese patients need to make lots of decisions on health care by themselves. This is because personal health consulting service (e.g. general practitioners) is not so popular in China; a large portion of citizens seek help from public hospitals. What makes it more complicated is that public hospitals in China are usually segmented into departments, and different hospitals may have specialty in different areas. As a result, patients in China need to choose a hospital based on their symptom time and time again.
After discussion with Professor Pan, I defined three main directions to work on:
- Under what situation would a Chinese patient choose modern medicine (MM), and when would s/he turn to traditional Chinese medicine (TCM)? This became the first question because patient self management of MM and that of TCM could be quite different. Acquisition of MM knowledge requires systematical learning and training while TCM emphasizes more on accumulation of experience. Chinese patients are eager to "find the best therapy by themselves", but they have to rely on professional doctors when making decisions on MM health service. In contrast, they can be more self-engaged in TCM.
- What help does a patient need during information collection and decision making? As mentioned above, Chinese patients need to make lots of decisions before the professional health service starts. If the information they need to make a decision go beyond their existing knowledge and experience, they have to search by themselves. To design a better self service system, help should be offered even before a patient decides which doctor to turn to.
- What needs to be improved in the existing medical care system? Self-service system was already available in some public hospitals in China, but its promotion were not going so smoothly since it was not user-friendly enough, especially for elder citizens. Many people preferred to wait in long queue before the check-in desk when self-service machines were available.
I made a decision model for Chinese patients based on interviews and focus group. The model helped to demonstrate what would make patients to choose MM or TCM, and what kind of service/information they would need during the procedure.
Another focus was language of patients. Most people do not know the actual meaning of medical terms, nor do they have access to help from professional doctors. I conducted a survey to find out what terms could be understood correctly and what could not. I also conducted a computer-based behavior experiment to see how people would pick out medical terms to describe symptoms.
Finally, I did a field study at a hospital to observe how people interact with the self-service system, and synthesized the user experience into a journey map.
Based on the protocol analysis of interviews and focus group, I completed the decision model of Chinese patients, including 6 stages from discovery of the symptom(s) to evaluation of the treatment. Specifically, I emphasized on the information input that patients would need and the output they would generate. These were highlighted for designers to build information architecture in the next phase of the long-term health system project.
I also designed a behavior experiment to see how fast people would respond to a medical term when they needed to reply whether they had the symptom currently. The trick of the experiment was that half of the participants were asked to take a tongue selfie before the experiment task started. Since tongue reading is a core skill of diagnosis in TCM, the behavior of sticking one's tongue out might temporarily activate one's interest in TCM, or encourage the patient to pay more attention to TCM terms. Under either explanation, the action of taking a tongue selfie could motivate user to take TCM terms more seriously, and they would be less likely to skip a tough word in TCM. Hence, to induce users to think for longer time on a TCM self-diagnose checklist, I would suggest to design a function of taking a tongue selfie before presenting the checklist.
After the field trip to a hospital with self-service system, I made the experience journey map and synthesized the pain points. Some were about the language or the order of actions that might cause confusion to the patients, and others were lack of detailed information or guidance when patients need help, or alignment problems between onsite terminal equipments and mobile application.
Had I got more time for this program, I would also make another journey map for patients' experience in a hospital without any self-service system, and compare the two kinds of experience. In that way, it would be clear to see where the self-system helped and where it caused pains.
As the prospect theory suggests, people make decisions based on potential gains and losses that they perceive. Chinese patients prefer traditional Chinese medicine when symptom is mild and/or chronic (low risk), but they choose modern medicine if symptom is severe and/or urgent (high risk). Patients can be guided to pay more attention to self diagnosis, and more information should be offered to patients to help them improve the quality of their decisions.